Aortic Stenosis (AS) is the most common primary valve disease leading to surgery or catheter intervention in Europe and North America.1 It is present in approximately 2% of the general population with a rising prevalence in the elderly (up to 6% in patients above 85 years old).2-4
Symptomatic AS has significant effects on a patient’s health and quality of life5,6 and many will have cardiovascular and other comorbidities, for example, other valvular diseases, diabetes mellitus, hypertension and peripheral vascular disease.7-11
Aortic Stenosis is the narrowing of the aortic orifice, typically as a result of degeneration and calcification of the valve leaflets.2
A normal aortic valve has an orifice of 3 to 4 cm.2,12 Narrowing of the valve becomes hemodynamically significant when the valve area is reduced to about 1 cm.2 AS leads to a less optimal flow of blood from the ventricle into the aorta and may result in Left Ventricle (LV) hypertrophy and decreased systemic and coronary circulation.
Anatomy of the aortic valve: types of aortic stenosis
Mild-to-Moderate Aortic Stenosis
Severe Aortic Stenosis
AS is a progressive disease. While patients with AS may initially be asymptomatic, further progression is typically associated with symptoms and poor prognosis.13,14 AS is associated with a significant risk of mortality, and survival is markedly reduced after the onset of symptoms.15
Natural history of AS:16
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- d'Arcy JL, Coffey S, Loudon MA et al. Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: the OxVALVE Population Cohort Study. Eur Heart J. 2016;37(47):3515–3522. doi.org/10.1093/eurheartj/ehw229.
- van Geldrop MWA, Heuvelman HJ, Kappetein AP et al. Quality of life among patients with severe aortic stenosis. Neth Heart J. 2013;21(1):21–27. doi.org/10.1007/s12471-012-0364-9.
- Oterhals K, Haaverstad R, Nordrehaug JE et al. Self-reported health status, treatment decision and survival in asymptomatic and symptomatic patients with aortic stenosis in a Western Norway population undergoing conservative treatment: a cross-sectional study with 18 months follow-up. BMJ Open. 2017;7(8):e016489. dx.doi.org/10.1136/bmjopen-2017-016489.
- Iung B, Baron G, Tornos P et al. Valvular heart disease in the community: a European experience. Curr Probl Cardiol. 2007;32(11):609–661. doi.org/10.1016/j.cpcardiol.2007.07.002.
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